Hypertension and insulin resistance in rheumatoid arthritis: unveiling insights with mets-ir index

Authors : Merve Nalbant, Emine Çetin

Pages : 314-320

Doi:10.18663/tjcl.1482825

View : 102 | Download : 96

Publication Date : 2024-09-30

Article Type : Research Paper

Abstract :Aim: Hypertension (HT), together with metabolic dysfunctions and insulin resistance (IR) in its pathophysiology, is a significant risk factor for cardiovascular disease in rheumatoid arthritis (RA) patients. Identifying IR early could enhance HT management, especially in RA patients, where HT prevalence is elevated. The study aimed to assess metabolic indices, particularly the METS-IR, as predictors of HT in RA patients. Material and Methods: This retrospective, cross-sectional study investigated the association between RA, IR, and HT in 80 RA patients and 80 age- and sex-matched controls. Patients with diabetes, pre-diabetes, or other conditions affecting insulin sensitivity were excluded, as were those on glucose-metabolism-affecting medications except low-dose glucocorticoids (<7.5 mg/day prednisone or equivalent). Results: RA patients exhibited significantly higher HT prevalence than controls (65% vs. 22.5%; p=0.044). HOMA-IR and METS-IR scores were significantly higher in RA patients (p=0.04 and p=0.01, respectively), while QUICKI scores were significantly lower (p=0.04). Glucocorticoid use didn’t affect METS-IR, HOMA-IR, or QUICKI scores. Hypertensive patients had significantly higher HOMA-IR and METS-IR scores (p=0.009 and p<0.001, respectively), with both showing a significant association with HT in multivariate analyses (p=0.002 for both). Age emerged as a significant factor in the development of HT, with each passing year increasing the likelihood by 7% (p=0.042). Conclusion: HT was more prevalent in RA patients, with higher METS-IR levels irrespective of glucocorticoid use or disease activity. Each unit increase in METS-IR score correlated with a 15% higher HT risk. METS-IR could serve as an early prediction tool for HT in RA.
Keywords : METS IR, Romatoid artrit, Hipertansiyon, İnsülin direnci, HOMA IR, Metabolik indeksler